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Omar A, Gul I, Ali I. Exploring vaccine hesitancy and acceptance in the general population of Pakistan: Insights into COVID-19-related distress, risk perception, and stigma. Hum Vaccin Immunother 2024; 20:2309699. [PMID: 38310646 PMCID: PMC10841009 DOI: 10.1080/21645515.2024.2309699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 01/20/2024] [Indexed: 02/06/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused several impacts. Focusing on 360 participants (178 males, 182 females), this study explored the association between COVID-19 related distress, risk perception, stigma, and vaccine hesitancy and acceptance in the general population. Measures used included the Hospital Anxiety and Depression Scale (HADS) and COVID Stress Scale (CSS) to evaluate anxiety, depression, and COVID-19 related distress, the COVID-19 Risk Perception Scale and COVID-19 Stigma Discrimination Scale to assess risk perception and stigma, and the Oxford COVID-19 Vaccine Hesitancy Scale and Vaccine Acceptance Instrument to measure vaccine hesitancy and acceptance. The findings revealed that 66.9% of participants exhibited vaccine hesitancy, and stress and risk perception were significant predictors of both vaccine hesitancy and acceptance, even after controlling for demographic factors. This study highlights the importance of understanding the factors mentioned above that will contribute to vaccine hesitancy and acceptance, which will contribute to promoting vaccine acceptance.
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Affiliation(s)
- Asma Omar
- Behavioral Sciences, Fatima Jinnah Women University, Rawalpindi, Pakistan
| | - Iram Gul
- Behavioral Sciences, Fatima Jinnah Women University, Rawalpindi, Pakistan
| | - Inayat Ali
- Department of Public Health and Allied Sciences, Fatima Jinnah Women University, Rawalpindi, Pakistan
- Department of Anthropology, Fatima Jinnah Women University, Rawalpindi, Pakistan
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
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2
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Lewis NM, Zhu Y, Peltan ID, Gaglani M, McNeal T, Ghamande S, Steingrub JS, Shapiro NI, Duggal A, Bender WS, Taghizadeh L, Brown SM, Hager DN, Gong MN, Mohamed A, Exline MC, Khan A, Wilson JG, Qadir N, Chang SY, Ginde AA, Mohr NM, Mallow C, Lauring AS, Johnson NJ, Gibbs KW, Kwon JH, Columbus C, Gottlieb RL, Raver C, Vaughn IA, Ramesh M, Johnson C, Lamerato L, Safdar B, Casey JD, Rice TW, Halasa N, Chappell JD, Grijalva CG, Talbot HK, Baughman A, Womack KN, Swan SA, Harker E, Price A, DeCuir J, Surie D, Ellington S, Self WH. Vaccine Effectiveness Against Influenza A-Associated Hospitalization, Organ Failure, and Death: United States, 2022-2023. Clin Infect Dis 2024; 78:1056-1064. [PMID: 38051664 DOI: 10.1093/cid/ciad677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Influenza circulation during the 2022-2023 season in the United States largely returned to pre-coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.2a, a close antigenic match to the vaccine strain. METHODS To understand effectiveness of the 2022-2023 influenza vaccine against influenza-associated hospitalization, organ failure, and death, a multicenter sentinel surveillance network in the United States prospectively enrolled adults hospitalized with acute respiratory illness between 1 October 2022, and 28 February 2023. Using the test-negative design, vaccine effectiveness (VE) estimates against influenza-associated hospitalization, organ failures, and death were measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative control-patients. RESULTS A total of 3707 patients, including 714 influenza cases (33% vaccinated) and 2993 influenza- and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative controls (49% vaccinated) were analyzed. VE against influenza-associated hospitalization was 37% (95% confidence interval [CI]: 27%-46%) and varied by age (18-64 years: 47% [30%-60%]; ≥65 years: 28% [10%-43%]), and virus (A[H3N2]: 29% [6%-46%], A[H1N1]: 47% [23%-64%]). VE against more severe influenza-associated outcomes included: 41% (29%-50%) against influenza with hypoxemia treated with supplemental oxygen; 65% (56%-72%) against influenza with respiratory, cardiovascular, or renal failure treated with organ support; and 66% (40%-81%) against influenza with respiratory failure treated with invasive mechanical ventilation. CONCLUSIONS During an early 2022-2023 influenza season with a well-matched influenza vaccine, vaccination was associated with reduced risk of influenza-associated hospitalization and organ failure.
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Affiliation(s)
- Nathaniel M Lewis
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Yuwei Zhu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ithan D Peltan
- Department of Medicine, Intermountain Medical Center, Murray, Utah, and University of Utah, Salt Lake City, Utah, USA
| | - Manjusha Gaglani
- Baylor Scott and White Health, Temple and Dallas, Texas, and Texas A&M University College of Medicine, Temple, Texas, USA
| | - Tresa McNeal
- Baylor Scott and White Health, and Baylor College of Medicine, Temple, Texas, USA
| | - Shekhar Ghamande
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Jay S Steingrub
- Department of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA
| | - Nathan I Shapiro
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Abhijit Duggal
- Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Leyla Taghizadeh
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Samuel M Brown
- Department of Medicine, Intermountain Medical Center, Murray, Utah, and University of Utah, Salt Lake City, Utah, USA
| | - David N Hager
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michelle N Gong
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Amira Mohamed
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Matthew C Exline
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Akram Khan
- Department of Medicine, Oregon Health and Sciences University, Portland, Oregon, USA
| | - Jennifer G Wilson
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Nida Qadir
- Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Steven Y Chang
- Department of Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nicholas M Mohr
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | | | - Adam S Lauring
- Departments of Internal Medicine and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicholas J Johnson
- Department of Emergency Medicine and Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA
| | - Kevin W Gibbs
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennie H Kwon
- Department of Medicine, Washington University, St.Louis, Missouri, USA
| | | | - Robert L Gottlieb
- Baylor University Medical Center Dallas, Baylor, Scott & White Heart and Vascular Hospital, Baylor, Scott and White Research Institute, Dallas, Texas, USA
| | | | - Ivana A Vaughn
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA
| | - Mayur Ramesh
- Division of Infectious Diseases, Henry Ford Health, Detroit, Michigan, USA
| | - Cassandra Johnson
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lois Lamerato
- Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA
| | - Basmah Safdar
- Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jonathan D Casey
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Todd W Rice
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James D Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - H Keipp Talbot
- Departments of Medicine and Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adrienne Baughman
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kelsey N Womack
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sydney A Swan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth Harker
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Ashley Price
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Jennifer DeCuir
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Diya Surie
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Sascha Ellington
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wesley H Self
- Department of Emergency Medicine, Vanderbilt Institute for Clinical and Translational Research, and Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Domnich A, Orsi A, Signori A, Chironna M, Manini I, Napoli C, Rizzo C, Panatto D, Icardi G. Waning intra-season vaccine effectiveness against influenza A(H3N2) underlines the need for more durable protection. Expert Rev Vaccines 2024; 23:380-388. [PMID: 38494919 DOI: 10.1080/14760584.2024.2331073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND The question of whether influenza vaccine effectiveness (VE) wanes over the winter season is still open and some contradictory findings have been reported. This study investigated the possible decline in protection provided by the available influenza vaccines. RESEARCH DESIGN AND METHODS An individual-level pooled analysis of six test-negative case-control studies conducted in Italy between the 2018/2019 and 2022/2023 seasons was performed. Multivariable logistic regression analyses were performed to estimate weekly change in the odds of testing positive for influenza 14 days after vaccination. RESULTS Of 6490 patients included, 1633 tested positive for influenza. Each week that had elapsed since vaccination was associated with an increase in the odds of testing positive for any influenza (4.9%; 95% CI: 2.0-8.0%) and for A(H3N2) (6.5%; 95% CI: 2.9-10.3%). This decline in VE was, however, significant only in children and older adults. A similar increase in the odds of testing positive was seen when the dataset was restricted to vaccinees only. Conversely, VE waning was less evident for A(H1N1)pdm09 or B strains. CONCLUSIONS Significant waning of VE, especially against influenza A(H3N2), may be one of the factors associated with suboptimal end-of-season VE. Next-generation vaccines should provide more durable protection against A(H3N2).
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Maria Chironna
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Ilaria Manini
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | | | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Interuniversity Research Centre on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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Martins JP, Santos M, Martins A, Felgueiras M, Santos R. Seasonal Influenza Vaccine Effectiveness in Persons Aged 15-64 Years: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:1322. [PMID: 37631889 PMCID: PMC10459161 DOI: 10.3390/vaccines11081322] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Influenza is a respiratory disease caused by the influenza virus, which is highly transmissible in humans. This paper presents a systematic review and meta-analysis of randomized controlled trials (RCTs) and test-negative designs (TNDs) to assess the vaccine effectiveness (VE) of seasonal influenza vaccines (SIVs) in humans aged 15 to 64 years. An electronic search to identify all relevant studies was performed. The outcome measure of interest was VE on laboratory-confirmed influenza (any strain). Quality assessment was performed using the Cochrane risk-of-bias tool for RCTs and the ROBINS-I tool for TNDs. The search identified a total of 2993 records, but only 123 studies from 73 papers were included in the meta-analysis. Of these studies, 9 were RCTs and 116 were TNDs. The pooled VE was 48% (95% CI: 42-54) for RCTs, 55.4% (95% CI: 43.2-64.9) when there was a match between the vaccine and most prevalent circulating strains and 39.3% (95% CI: 23.5-51.9) otherwise. The TNDs' adjusted VE was equal to 39.9% (95% CI: 31-48), 45.1 (95% CI: 38.7-50.8) when there was a match and 35.1 (95% CI: 29.0-40.7) otherwise. The match between strains included in the vaccine and strains in circulation is the most important factor in the VE. It increases by more than 25% when there is a match with the most prevalent circulating strains. The laboratorial method for confirmation of influenza is a possible source of bias when estimating VE.
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Affiliation(s)
- João Paulo Martins
- Escola Superior de Saúde, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
- CEAUL—Centro de Estatística e Aplicações, Faculdade de Ciências, Campo Grande, Universidade de Lisboa, 1749-016 Lisboa, Portugal; (M.F.); (R.S.)
| | - Marlene Santos
- Escola Superior de Saúde, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
- Centro de Investigação em Saúde e Ambiente, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
| | - André Martins
- Centro de Investigação em Saúde e Ambiente, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal;
| | - Miguel Felgueiras
- CEAUL—Centro de Estatística e Aplicações, Faculdade de Ciências, Campo Grande, Universidade de Lisboa, 1749-016 Lisboa, Portugal; (M.F.); (R.S.)
- Escola Superior de Tecnologia e Gestão, Instituto Politécnico de Leiria, Campus 2, Morro do Lena—Alto do Vieiro, Apartado 4163, 2411-901 Leiria, Portugal
| | - Rui Santos
- CEAUL—Centro de Estatística e Aplicações, Faculdade de Ciências, Campo Grande, Universidade de Lisboa, 1749-016 Lisboa, Portugal; (M.F.); (R.S.)
- Escola Superior de Tecnologia e Gestão, Instituto Politécnico de Leiria, Campus 2, Morro do Lena—Alto do Vieiro, Apartado 4163, 2411-901 Leiria, Portugal
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5
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Tenforde MW, Patel MM, Lewis NM, Adams K, Gaglani M, Steingrub JS, Shapiro NI, Duggal A, Prekker ME, Peltan ID, Hager DN, Gong MN, Exline MC, Ginde AA, Mohr NM, Mallow C, Martin ET, Talbot HK, Gibbs KW, Kwon JH, Chappell JD, Halasa N, Lauring AS, Lindsell CJ, Swan SA, Hart KW, Womack KN, Baughman A, Grijalva CG, Self WH. Vaccine Effectiveness Against Influenza A(H3N2)-Associated Hospitalized Illness: United States, 2022. Clin Infect Dis 2023; 76:1030-1037. [PMID: 36327388 PMCID: PMC10226741 DOI: 10.1093/cid/ciac869] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic was associated with historically low influenza circulation during the 2020-2021 season, followed by an increase in influenza circulation during the 2021-2022 US season. The 2a.2 subgroup of the influenza A(H3N2) 3C.2a1b subclade that predominated was antigenically different from the vaccine strain. METHODS To understand the effectiveness of the 2021-2022 vaccine against hospitalized influenza illness, a multistate sentinel surveillance network enrolled adults aged ≥18 years hospitalized with acute respiratory illness and tested for influenza by a molecular assay. Using the test-negative design, vaccine effectiveness (VE) was measured by comparing the odds of current-season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative controls, adjusting for confounders. A separate analysis was performed to illustrate bias introduced by including SARS-CoV-2-positive controls. RESULTS A total of 2334 patients, including 295 influenza cases (47% vaccinated), 1175 influenza- and SARS-CoV-2-negative controls (53% vaccinated), and 864 influenza-negative and SARS-CoV-2-positive controls (49% vaccinated), were analyzed. Influenza VE was 26% (95% CI: -14% to 52%) among adults aged 18-64 years, -3% (-54% to 31%) among adults aged ≥65 years, and 50% (15-71%) among adults aged 18-64 years without immunocompromising conditions. Estimated VE decreased with inclusion of SARS-CoV-2-positive controls. CONCLUSIONS During a season where influenza A(H3N2) was antigenically different from the vaccine virus, vaccination was associated with a reduced risk of influenza hospitalization in younger immunocompetent adults. However, vaccination did not provide protection in adults ≥65 years of age. Improvements in vaccines, antivirals, and prevention strategies are warranted.
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Affiliation(s)
- Mark W Tenforde
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manish M Patel
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nathaniel M Lewis
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine Adams
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Manjusha Gaglani
- Baylor Scott and White Health, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Jay S Steingrub
- Department of Medicine, Baystate Medical Center, Springfield, Massachusetts, USA
| | - Nathan I Shapiro
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Abhijit Duggal
- Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Matthew E Prekker
- Departments of Emergency Medicine and Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Ithan D Peltan
- Department of Medicine, Intermountain Medical Center, Murray, Utah and University of Utah, Salt Lake City, Utah, USA
| | - David N Hager
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michelle N Gong
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Matthew C Exline
- Department of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nicholas M Mohr
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA
| | | | - Emily T Martin
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - H Keipp Talbot
- Departments of Medicine and Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kevin W Gibbs
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennie H Kwon
- Department of Medicine, Washington University, St Louis, Missouri, USA
| | - James D Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adam S Lauring
- Departments of Internal Medicine and Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA
| | - Christopher J Lindsell
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sydney A Swan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kimberly W Hart
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kelsey N Womack
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adrienne Baughman
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wesley H Self
- Vanderbilt Institute for Clinical and Translational Research and Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Loconsole D, Centrone F, Aprile V, Sallustio A, Casulli D, Accogli M, Sacco D, Zagaria R, Chironna M. What's Next for Flu? Out-of-Season Circulation of Influenza Viruses in Southern Italy, August 2022. Viruses 2022; 14:v14122689. [PMID: 36560693 PMCID: PMC9783519 DOI: 10.3390/v14122689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
The COVID-19 pandemic has modified the seasonal pattern of respiratory infections. The objective of the present study is to characterize the out-of-season circulation of influenza viruses and an influenza outbreak that occurred in southern Italy in August 2022. Nasopharyngeal swabs collected from patients with influenza-like illnesses (ILI) were tested for the presence of influenza and other respiratory viruses. Epidemiological investigations on 85 patients involved in an influenza outbreak were performed. Sequencing and phylogenetic analysis of hemagglutinin genes was undertaken on samples positive for influenza A. In August 2022, in the Apulia region (Italy), influenza A infection was diagnosed in 19 patients, 18 infected with A/H3N2 and one with A/H1N1pdm09 virus. Seven influenza-positive patients were hospitalized with ILI. A further 17 symptomatic subjects, associated with an influenza outbreak, were also tested; 11 were positive for influenza A/H3N2 virus. Phylogenetic analysis of 12 of the A/H3N2 sequences showed that they all belonged to subclade 3C.2a1b.2a.2. The A/H1N1pdm09 strain belonged to subclade 6B.1A.5a.2. The out-of-season circulation of the influenza virus during the summer months could be linked to changing dynamics in the post-COVID-19 era, as well as to the impact of climate change. Year-round surveillance of respiratory viruses is needed to monitor this phenomenon and to provide effective prevention strategies.
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Affiliation(s)
- Daniela Loconsole
- Department of Interdisciplinary Medicine, Hygiene Section, University of Bari, 70124 Bari, Italy
| | - Francesca Centrone
- Department of Interdisciplinary Medicine, Hygiene Section, University of Bari, 70124 Bari, Italy
| | - Valerio Aprile
- Department of Prevention, Local Health Unit of Lecce, 73100 Lecce, Italy
| | - Anna Sallustio
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Daniele Casulli
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Marisa Accogli
- Department of Interdisciplinary Medicine, Hygiene Section, University of Bari, 70124 Bari, Italy
| | - Davide Sacco
- Department of Interdisciplinary Medicine, Hygiene Section, University of Bari, 70124 Bari, Italy
| | - Riccardo Zagaria
- Department of Interdisciplinary Medicine, Hygiene Section, University of Bari, 70124 Bari, Italy
| | - Maria Chironna
- Department of Interdisciplinary Medicine, Hygiene Section, University of Bari, 70124 Bari, Italy
- Correspondence: ; Tel.: +39-080-5478498; Fax: +39-080-5593887
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7
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Domnich A, Panatto D, Pariani E, Napoli C, Chironna M, Manini I, Rizzo C, Orsi A, Icardi G. Relative effectiveness of the adjuvanted vs non-adjuvanted seasonal influenza vaccines against severe laboratory-confirmed influenza among hospitalized Italian older adults. Int J Infect Dis 2022; 125:164-169. [PMID: 36332902 DOI: 10.1016/j.ijid.2022.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES In this study, we aimed to investigate the relative vaccine effectiveness (rVE) of the MF59-adjuvanted trivalent (aTIV) and non-adjuvanted quadrivalent (QIVe) egg-based standard-dose vaccines against severe laboratory-confirmed influenza. METHODS This test-negative case-control study was conducted in a hospital setting during four recent Italian influenza seasons (from 2018/19 to 2021/22). The clinical outcome was severe acute respiratory infection (SARI) with laboratory confirmation diagnosed among subjects aged ≥65 years. rVE of aTIV versus QIVe was estimated through propensity score matching followed by logistic regression. RESULTS The influenza virus circulated to a significant extent only during the 2018/19 and 2019/20 seasons. The final population included 512 vaccinated older adults, of which 83 were cases and 429 were test-negative controls. aTIV and QIVe users differed substantially from the point of view of several baseline characteristics. The propensity score adjusted rVE of aTIV vs QIVe was 59.2% (95% CI: 14.6%, 80.5%), 54.7% (95% CI: -28.7%, 84.0%) and 56.9% (95% CI: -7.8%, 82.8%) against any influenza, A(H1N1)pdm09 and A(H3N2), respectively. CONCLUSION aTIV was more effective than QIVe in preventing laboratory-confirmed SARI. The benefits of aTIV may be obscured by confounding indication.
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Affiliation(s)
- Alexander Domnich
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Elena Pariani
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Maria Chironna
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Ilaria Manini
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy; Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Caterina Rizzo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Andrea Orsi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
| | - Giancarlo Icardi
- Hygiene Unit, San Martino Policlinico Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy; Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy
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CALABRÒ GIOVANNAELISA, ICARDI GIANCARLO, BONANNI PAOLO, GABUTTI GIOVANNI, VITALE FRANCESCO, RIZZO CATERINA, CICCHETTI AMERICO, STAIANO ANNAMARIA, ANSALDI FILIPPO, ORSI ANDREA, DE WAURE CHIARA, PANATTO DONATELLA, AMICIZIA DANIELA, BERT FABRIZIO, VILLANI ALBERTO, IERACI ROBERTO, CONVERSANO MICHELE, RUSSO CARMELA, RUMI FILIPPO, SCOTTI SILVESTRO, MAIO TOMMASA, RUSSO ROCCO, VACCARO CONCETTAMARIA, SILIQUINI ROBERTA, RICCIARDI WALTER. [Flu vaccination and value-based health care: operational solutions to safeguard public health]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E1-E85. [PMID: 36310765 PMCID: PMC9586154 DOI: 10.15167/2421-4248/jpmh2022.63.2s2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- GIOVANNA ELISA CALABRÒ
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma
- VIHTALI - Value In Health Technology and Academy for Leadership & Innovation, Spin-Off dell'Università Cattolica del Sacro Cuore, Roma
- Autore corrispondente: Giovanna Elisa Calabrò, Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia - E-mail:
| | - GIANCARLO ICARDI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
- U.O. Igiene, IRCCS Ospedale Policlinico San Martino, Genova
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute (DSS), Università di Firenze
| | - GIOVANNI GABUTTI
- Coordinatore Nazionale GdL Vaccini e Politiche Vaccinali della SItI
| | - FRANCESCO VITALE
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro”, Università degli Studi di Palermo
| | - CATERINA RIZZO
- Dipartimento di ricerca traslazionale e nuove tecnologie in medicina e chirurgia, Università degli Studi di Pisa
| | - AMERICO CICCHETTI
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma
| | - ANNAMARIA STAIANO
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi “Federico II”, Napoli
- Presidente Società Italiana di Pediatria (SIP)
| | - FILIPPO ANSALDI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
- A.Li.Sa. Azienda Ligure Sanitaria Regione Liguria
| | - ANDREA ORSI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
- U.O. Igiene, IRCCS Ospedale Policlinico San Martino, Genova
| | - CHIARA DE WAURE
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia
| | - DONATELLA PANATTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - DANIELA AMICIZIA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
- A.Li.Sa. Azienda Ligure Sanitaria Regione Liguria
| | - FABRIZIO BERT
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino
- SSDU Igiene Ospedaliera e Governo delle Infezioni Correlate all’Assistenza, ASL TO3
| | - ALBERTO VILLANI
- Dipartimento Emergenza Accettazione Ospedale Pediatrico Bambino Gesù, IRCCS, Roma
- Dipartimento di Medicina dei Sistemi, Università di Roma Tor Vergata
| | - ROBERTO IERACI
- Strategie vaccinali, Regione Lazio
- Ricercatore associato CID Ethics-CNR
| | | | - CARMELA RUSSO
- U.O.S.V.D. Epidemiologia - Comunicazione e Formazione Coordinamento delle Attività di Promozione della Salute e di Educazione Sanitaria, ASL Taranto
| | - FILIPPO RUMI
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Roma
| | | | - TOMMASA MAIO
- Federazione Italiana Medici di Medicina Generale (FIMMG)
| | - ROCCO RUSSO
- Coordinatore tavolo tecnico vaccinazioni, Società Italiana di Pediatria (SIP)
| | | | - ROBERTA SILIQUINI
- Dipartimento di Scienze della Sanità Pubblica e Pediatriche, Università degli Studi di Torino
- AOU Città della Salute e della Scienza di Torino
| | - WALTER RICCIARDI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma
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MADE: A Computational Tool for Predicting Vaccine Effectiveness for the Influenza A(H3N2) Virus Adapted to Embryonated Eggs. Vaccines (Basel) 2022; 10:vaccines10060907. [PMID: 35746515 PMCID: PMC9227319 DOI: 10.3390/vaccines10060907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 01/29/2023] Open
Abstract
Seasonal Influenza H3N2 virus poses a great threat to public health, but its vaccine efficacy remains suboptimal. One critical step in influenza vaccine production is the viral passage in embryonated eggs. Recently, the strength of egg passage adaptation was found to be rapidly increasing with time driven by convergent evolution at a set of functionally important codons in the hemagglutinin (HA1). In this study, we aim to take advantage of the negative correlation between egg passage adaptation and vaccine effectiveness (VE) and develop a computational tool for selecting the best candidate vaccine virus (CVV) for vaccine production. Using a probabilistic approach known as mutational mapping, we characterized the pattern of sequence evolution driven by egg passage adaptation and developed a new metric known as the adaptive distance (AD) which measures the overall strength of egg passage adaptation. We found that AD is negatively correlated with the influenza H3N2 vaccine effectiveness (VE) and ~75% of the variability in VE can be explained by AD. Based on these findings, we developed a computational package that can Measure the Adaptive Distance and predict vaccine Effectiveness (MADE). MADE provides a powerful tool for the community to calibrate the effect of egg passage adaptation and select more reliable strains with minimum egg-passaged changes as the seasonal A/H3N2 influenza vaccine.
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10
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Calabrò GE, Boccalini S, Panatto D, Rizzo C, Di Pietro ML, Abreha FM, Ajelli M, Amicizia D, Bechini A, Giacchetta I, Lai PL, Merler S, Primieri C, Trentini F, Violi S, Bonanni P, de Waure C. The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074166. [PMID: 35409848 PMCID: PMC8998177 DOI: 10.3390/ijerph19074166] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/15/2022]
Abstract
Background. The elderly, commonly defined as subjects aged ≥65 years, are among the at-risk subjects recommended for annual influenza vaccination in European countries. Currently, two new vaccines are available for this population: the MF59-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose quadrivalent influenza vaccine (hdQIV). Their multidimensional assessment might maximize the results in terms of achievable health benefits. Therefore, we carried out a Health Technology Assessment (HTA) of the aQIV by adopting a multidisciplinary policy-oriented approach to evaluate clinical, economic, organizational, and ethical implications for the Italian elderly. Methods. A HTA was conducted in 2020 to analyze influenza burden; characteristics, efficacy, and safety of aQIV and other available vaccines for the elderly; cost-effectiveness of aQIV; and related organizational and ethical implications. Comprehensive literature reviews/analyses were performed, and a transmission model was developed in order to address the above issues. Results. In Italy, the influenza burden on the elderly is high and from 77.7% to 96.1% of influenza-related deaths occur in the elderly. All available vaccines are effective and safe; however, aQIV, such as the adjuvanted trivalent influenza vaccine (aTIV), has proved more immunogenic and effective in the elderly. From the third payer’s perspective, but also from the societal one, the use of aQIV in comparison with egg-based standard QIV (eQIV) in the elderly population is cost-effective. The appropriateness of the use of available vaccines as well as citizens’ knowledge and attitudes remain a challenge for a successful vaccination campaign. Conclusions. The results of this project provide decision-makers with important evidence on the aQIV and support with scientific evidence on the appropriate use of vaccines in the elderly.
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Affiliation(s)
- Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence:
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Donatella Panatto
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Caterina Rizzo
- Clinical Pathways and Epidemiology Unit-Medical Direction, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Maria Luisa Di Pietro
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Fasika Molla Abreha
- Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN 47405, USA;
| | - Daniela Amicizia
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Angela Bechini
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Irene Giacchetta
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Piero Luigi Lai
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (D.P.); (D.A.); (P.L.L.)
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, 38122 Trento, Italy; (S.M.); (F.T.)
| | - Chiara Primieri
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, 38122 Trento, Italy; (S.M.); (F.T.)
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, 20136 Milan, Italy
| | - Sara Violi
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50121 Florence, Italy; (S.B.); (A.B.); (P.B.)
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy; (I.G.); (C.P.); (S.V.); (C.d.W.)
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11
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BOCCALINI SARA, PARIANI ELENA, CALABRÒ GIOVANNAELISA, DE WAURE CHIARA, PANATTO DONATELLA, AMICIZIA DANIELA, LAI PIEROLUIGI, RIZZO CATERINA, AMODIO EMANUELE, VITALE FRANCESCO, CASUCCIO ALESSANDRA, DI PIETRO MARIALUISA, GALLI CRISTINA, BUBBA LAURA, PELLEGRINELLI LAURA, VILLANI LEONARDO, D’AMBROSIO FLORIANA, CAMINITI MARTA, LORENZINI ELISA, FIORETTI PAOLA, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, CANTOVA ELISA, PARENTE FLAVIO, TRENTO GIACOMO, SOTTILE SARA, PUGLIESE ANDREA, BIAMONTE MASSIMILIANOALBERTO, GIORGETTI DUCCIO, MENICACCI MARCO, D’ANNA ANTONIO, AMMOSCATO CLAUDIA, LA GATTA EMANUELE, BECHINI ANGELA, BONANNI PAOLO. [Health Technology Assessment (HTA) of the introduction of influenza vaccination for Italian children with Fluenz Tetra ®]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E118. [PMID: 34909481 PMCID: PMC8639053 DOI: 10.15167/2421-4248/jpmh2021.62.2s1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
- Autore corrispondente: Sara Boccalini, Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50134 Firenze, Italia - Tel.: 055-2751084 - E-mail:
| | - ELENA PARIANI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
| | - GIOVANNA ELISA CALABRÒ
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), spin off dell’Università Cattolica del Sacro Cuore, Roma, Italia
| | - CHIARA DE WAURE
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - DONATELLA PANATTO
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - DANIELA AMICIZIA
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - PIERO LUIGI LAI
- Centro Interuniversitario per la Ricerca sull'Influenza e le altre Infezioni Trasmissibili CIRI-IT, Italia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - CATERINA RIZZO
- Area Funzionale Percorsi Clinici ed Epidemiologia, Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italia
| | - EMANUELE AMODIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - FRANCESCO VITALE
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - ALESSANDRA CASUCCIO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - MARIA LUISA DI PIETRO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - CRISTINA GALLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA BUBBA
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LAURA PELLEGRINELLI
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italia
| | - LEONARDO VILLANI
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - FLORIANA D’AMBROSIO
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - MARTA CAMINITI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - ELISA LORENZINI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | - PAOLA FIORETTI
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italia
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - ELISA CANTOVA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - FLAVIO PARENTE
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - GIACOMO TRENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genova, Italia
| | - SARA SOTTILE
- Università degli Studi di Trento, Trento, Italia
| | | | | | - DUCCIO GIORGETTI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - MARCO MENICACCI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - ANTONIO D’ANNA
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - CLAUDIA AMMOSCATO
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro”, Università degli Studi di Palermo, Palermo, Italia
| | - EMANUELE LA GATTA
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze, Firenze, Italia
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Kuliese M, Mickiene A, Jancoriene L, Zablockiene B, Gefenaite G. Age-Specific Seasonal Influenza Vaccine Effectiveness against Different Influenza Subtypes in the Hospitalized Population in Lithuania during the 2015-2019 Influenza Seasons. Vaccines (Basel) 2021; 9:vaccines9050455. [PMID: 34064455 PMCID: PMC8147944 DOI: 10.3390/vaccines9050455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Continuous monitoring of seasonal influenza vaccine effectiveness (SIVE) is needed due to the changing nature of influenza viruses and it supports the decision on the annual update of vaccine composition. Age-specific SIVE was evaluated against different influenza subtypes in the hospitalized population in Lithuania during four influenza seasons. Methods: A test-negative case-control study design was used. SIVE and its 95% confidence intervals (95% CI) were calculated as (1 – odds ratio (OR)) × 100%. Results: Adjusted SIVE in 18–64-year-old individuals against influenza A, A(H1N1)pdm09 and B/Yamagata were 78.0% (95% CI: 1.7; 95.1%), 88.6% (95% CI: −47.4; 99.1%), and 76.8% (95% CI: −109.9; 97.4%), respectively. Adjusted SIVE in individuals aged 65 years and older against influenza A, influenza B, and B/Yamagata were 22.6% (95% CI: −36.5; 56.1%), 75.3% (95% CI: 12.2; 93.1%) and 73.1% (95% CI: 3.2; 92.5%), respectively. Unadjusted SIVE against influenza A(H3N2) among 18–64-year-old patients was 44.8% (95% CI: −171.0; 88.8%) and among those aged 65 years and older was 5.0% (95% CI: −74.5; 48.3%). Conclusions: Point estimates suggest high SIVE against influenza A in 18–64-year-old participants, and against influenza B and B/Yamagata in those 65 years old and older.
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Affiliation(s)
- Monika Kuliese
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, 47116 Kaunas, Lithuania; (A.M.); (G.G.)
- Correspondence:
| | - Aukse Mickiene
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, 47116 Kaunas, Lithuania; (A.M.); (G.G.)
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Street 14, 08406 Vilnius, Lithuania; (L.J.); (B.Z.)
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Santariskiu Street 14, 08406 Vilnius, Lithuania
| | - Birute Zablockiene
- Clinic of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Street 14, 08406 Vilnius, Lithuania; (L.J.); (B.Z.)
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Santariskiu Street 14, 08406 Vilnius, Lithuania
| | - Giedre Gefenaite
- Department of Infectious Diseases, Lithuanian University of Health Sciences, Baltijos Street 120, 47116 Kaunas, Lithuania; (A.M.); (G.G.)
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 22100 Lund, Sweden
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13
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Manini I, Camarri A, Marchi S, Trombetta CM, Vicenti I, Dragoni F, Lazzeri G, Bova G, Montomoli E, Capecchi PL. Surveillance for Severe Acute Respiratory Infections among Hospitalized Subjects from 2015/2016 to 2019/2020 Seasons in Tuscany, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083875. [PMID: 33917106 PMCID: PMC8067855 DOI: 10.3390/ijerph18083875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 11/20/2022]
Abstract
In Italy, the influenza season lasts from October until April of the following year. Influenza A and B viruses are the two viral types that cocirculate during seasonal epidemics and are the main causes of respiratory infections. We analyzed influenza A and B viruses in samples from hospitalized patients at Le Scotte University Hospital in Siena (Central Italy). From 2015 to 2020, 182 patients with Severe Acute Respiratory Infections were enrolled. Oropharyngeal swabs were collected from patients and tested by means of reverse transcriptase-polymerase chain reaction to identify influenza A(H3N2), A(H1N1)pdm09 and B. Epidemiological and virological surveillance remain an essential tool for monitoring circulating viruses and possible mismatches with seasonal vaccine strains, and provide information that can be used to improve the composition of influenza vaccines.
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Affiliation(s)
- Ilaria Manini
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy
- Correspondence:
| | - Andrea Camarri
- Emergency and Transplants Department, University Hospital of Siena, Viale Bracci 16, 53100 Siena, Italy; (A.C.); (G.B.)
| | - Serena Marchi
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
| | - Claudia Maria Trombetta
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy
| | - Ilaria Vicenti
- Department of Medical Biotechnologies, University of Siena, Viale Bracci 16, 53100 Siena, Italy; (I.V.); (F.D.)
| | - Filippo Dragoni
- Department of Medical Biotechnologies, University of Siena, Viale Bracci 16, 53100 Siena, Italy; (I.V.); (F.D.)
| | - Giacomo Lazzeri
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy
| | - Giovanni Bova
- Emergency and Transplants Department, University Hospital of Siena, Viale Bracci 16, 53100 Siena, Italy; (A.C.); (G.B.)
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy; (S.M.); (C.M.T.); (G.L.); (E.M.)
- Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Via Pastore 1, 16132 Genoa, Italy
- VisMederi S.r.l., Strada del Petriccio e Belriguardo 35, 53100 Siena, Italy
| | - Pier Leopoldo Capecchi
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci 16, 53100 Siena, Italy;
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No Evidence of SARS-CoV-2 Circulation in Rome (Italy) during the Pre-Pandemic Period: Results of a Retrospective Surveillance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228461. [PMID: 33207548 PMCID: PMC7696939 DOI: 10.3390/ijerph17228461] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 02/07/2023]
Abstract
In March 2020, the World Health Organization (WHO) declared that the COVID-19 outbreak recorded over the previous months could be characterized as a pandemic. The first known Italian SARS-CoV-2 positive case was reported on 21 February. In some countries, cases of suspected “COVID-19-like pneumonia” had been reported earlier than those officially accepted by health authorities. This has led many investigators to check preserved biological or environmental samples to see whether the virus was detectable on dates prior to those officially stated. With regard to Italy, the results of a microbiological screening in sewage samples collected between the end of February and the beginning of April 2020 from wastewaters in Milan (Northern Italy) and Rome (Central Italy) showed presence of SARS-CoV-2. In the present study, we evaluated, by means of a standardized diagnostic method, the SARS-CoV-2 infection prevalence amongst patients affected by severe acute respiratory syndrome (SARI) in an academic hospital located in Central Italy during the period of 1 November 2019–1 March 2020. Overall, the number of emergency room (ER) visits during the investigated period was 13,843. Of these, 1208 had an influenza-like syndrome, but only 166 matched the definition of SARI as stated in the study protocol. A total of 52 SARI cases were laboratory confirmed as influenza: 26 as a type B virus, 25 as a type A, and 1 as both viruses. Although about 17% of the total sample had laboratory or radiological data compatible with COVID-19, all the nasopharyngeal swabs stored underwent SARS-CoV-2 RT-PCR and tested negative. Based on our result, it is confirmed that the COVID-19 pandemic spread did not start prior to the “official” onset in central Italy. Routine monitoring of SARI causative agents at the local level is critical for reporting epidemiologic and etiologic trends that may differ from one country to another and also among different influenza seasons. This has a practical impact on prevention and control strategies.
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